‫ﻓﺸﺎﺭ ﺧﻮﻥ ﻭ ﺍﻧﺪﺍﺯﻩ ﮔﻴﺮﻱ ﺁﻥ ﺑﺎ ﺍﺳﻔﻴﮕﻤﻮﻣﺎﻧﻮﻣﺘﺮ‬

‫ﻣﻘﺪﻣﻪ‪ :‬ﻓﺸﺎﺭﺧﻮﻥ ﻧﻴﺮﻭﻳﻲ ﺍﺳﺖ ﻛﻪ ﺧﻮﻥ ﺑﻪ ﻭﺍﺣﺪ ﺳﻄﺢ ﺩﻳﻮﺍﺭﻩ ﻋﺮﻭﻕ ﺍﻋﻤﺎﻝ ﻣﻲﻛﻨﺪ‪ .P= .‬ﻭﻗﺘﻲ ﮔﻔﺘﻪ ﻣﻲﺷﻮﺩ ﻓﺸﺎﺭ‬
‫‪ 50‬ﻣﻴﻠﻴﻤﺘﺮ ﺟﻴﻮﻩ ﺍﺳﺖ ﻳﻌﻨﻲ ﻧﻴﺮﻭﻳﻲ ﻛﻪ ﺳﺘﻮﻥ ﺟﻴﻮﻩ ﺭﺍ ﺧﻼﻑ ﻧﻴﺮﻭﻱ ﺟﺎﺫﺑﻪ ﺗﺎ ﺍﺭﺗﻔﺎﻉ ‪ 50‬ﻣﻴﻠﻴﻤﺘﺮ ﺑﺎﻻ ﻣﻲﺑﺮﺩ‪ .‬ﻭﺍﺣﺪ‬
‫ﻓﺸﺎﺭ ﻋﻼﻭﻩ ﺑﺮ ﻣﻴﻠﻴﻤﺘﺮ ﺟﻴﻮﻩ‪ ،‬ﻓﺸﺎﺭ ﺑﺮ ﺣﺴﺐ ﺳﺎﻧﺘﻲﻣﺘﺮ ﺁﺏ ﻫﻢ ﺍﻧﺪﺍﺯﻩﮔﻴﺮﻱ ﻣﻲﺷﻮﺩ‪ .‬ﻳﻚ ﻓﺸﺎﺭ ‪ 10‬ﺳﺎﻧﺘﻴﻤﺘﺮ ﺁﺏ‬
‫ﻧﻴﺮﻭﻳﻲ ﺍﺳﺖ ﻛﻪ ﺳﺘﻮﻥ ﺁﺏ ﺭﺍ ﺗﺎ ﺍﺭﺗﻔﺎﻉ ‪ 10‬ﺳﺎﻧﺘﻲ ﻣﺘﺮ ﺑﺮ ﺧﻼﻑ ﺟﺎﺫﺑﻪ ﺑﺎﻻ ﻣﻲ ﺑﺮﺩ‪ .‬ﻳﻚ ﻣﻴﻠﻴﻤﺘﺮ ﺟﻴﻮﻩ ﻓﺸﺎﺭ ﺑﺮﺍﺑﺮ ﺍﺳﺖ‬
‫ﺑﺎ ﻓﺸﺎﺭ ‪ 1/36‬ﺳﺎﻧﺘﻴﻤﺘﺮ ﺁﺏ‪.‬‬
‫ﺩﺭ ﺩﺳﺘﮕﺎﻩ ﮔﺮﺩﺵ ﺧﻮﻥ ﺑﻴﺸﺘﺮﻳﻦ ﻓﺸﺎﺭ ﺩﺭ ﺳﻴﺴﺘﻢ ﺷﺮﻳﺎﻧﻲ ﺍﺳﺖ ﻭ ﺑﺎ ﻭﺭﻭﺩ ﺧﻮﻥ ﺑﻪ ﺳﺎﻳﺮ ﺑﺨﺸﻬﺎﻱ ﺍﻳﻦ ﺳﻴﺴﺘﻢ‪ ،‬ﻓﺸﺎﺭ‬
‫ﻛﺎﻫﺶ ﻣﻲﻳﺎﺑﺪ‪ .‬ﻛﺎﻫﺶ ﻓﺸﺎﺭ ﺑﻪ ﻋﻠﺖ ﻛﺎﻫﺶ ﺍﻧﺮژﻱ ﺧﻮﻥ ﻛﻪ ﺑﻪ ﻋﻠﺖ ﺍﻓﺰﺍﻳﺶ ﻣﻘﺎﻭﻣﺖ ﺩﺭ ﺑﺮﺍﺑﺮ ﺟﺮﻳﺎﻥ ﺧﻮﻥ ﺍﺳﺖ‪ .‬ﺍﻳﻦ‬
‫ﻣﻘﺎﻭﻣﺖ ﺑﺨﺸﻲ ﺑﻪ ﻋﻠﺖ ﺩﻳﻮﺍﺭﻩ ﻋﺮﻭﻕ ﻭ ﺑﺨﺸﻲ ﺑﻪ ﺩﻟﻴﻞ ﺳﻠﻮﻝﻫﺎﻱ ﺧﻮﻧﻲ ﺍﺳﺖ‪.‬‬
‫ﺩﺭ ﮔﺮﺩﺵ ﺧﻮﻥ ﺳﻴﺴﺘﻤﻴﻚ ﺑﻴﺸﺘﺮﻳﻦ ﺣﺪ ﻓﺸﺎﺭ ﺩﺭ ﺁﺋﻮﺭﺕ ﺍﺳﺖ ﻛﻪ ﻣﻨﻌﻜﺲ ﻛﻨﻨﺪﻩ ﻓﺸﺎﺭ ﺑﻄﻦ ﭼﭗ ﺍﺳﺖ‪ .‬ﺩﺭ ﺍﻓﺮﺍﺩ ﺳﺎﻟﻢ‬
‫ﺑﻄﻮﺭ ﻣﺘﻮﺳﻂ ‪ 120‬ﻣﻴﻠﻴﻤﺘﺮ ﺟﻴﻮﻩ‪ .‬ﺍﻳﻦ ﻓﺸﺎﺭ ﺑﻪ ﺩﻟﻴﻞ ﻣﺮﺣﻠﻪ ﺳﻴﺴﺘﻮﻝ ﺑﻄﻦ ﭼﭗ ﺍﻳﺠﺎﺩ ﻣﻲﺷﻮﺩ ﻭ ﻓﺸﺎﺭ ﺳﻴﺴﺘﻮﻟﻲ‬
‫ﻧﺎﻣﻴﺪﻩ ﻣﻲﺷﻮﺩ‪ .‬ﺍﻳﻦ ﻓﺸﺎﺭ ﺑﺘﺪﺭﻳﺞ ﻛﺎﻫﺶ ﻣﻲﻳﺎﺑﺪ ﻭ ﺑﻪ ‪ 80‬ﻣﻴﻠﻴﻤﺘﺮ ﺟﻴﻮﻩ ﺩﺭ ﻣﺮﺣﻠﻪ ﺩﻳﺎﺳﺘﻮﻝ ﺑﻄﻦ ﭼﭗ ﻣﻲﺭﺳﺪ‪ .‬ﺍﻳﻦ ﺩﺭ‬
‫ﺣﺎﻟﻲ ﺍﺳﺖ ﻛﻪ ﻓﺸﺎﺭ ﺑﻄﻦ ﭼﭗ ﺩﺭ ﻫﻨﮕﺎﻡ ﺩﻳﺎﺳﺘﻮﻝ ﻛﻪ ﻋﻀﻠﻪ ﻗﻠﺐ ﺩﺭ ﻣﺮﺣﻠﻪ ﺍﺳﺘﺮﺍﺣﺖ ﺍﺳﺖ‪ ،‬ﺻﻔﺮ ﻣﻴﻠﻴﻤﺘﺮ ﺟﻴﻮﻩ ﺍﺳﺖ‪.‬‬
‫ﻋﻠﺖ ﺍﻳﻨﻜﻪ ﻓﺸﺎﺭ ﺩﻳﺎﺳﺘﻮﻝ ﺷﺮﻳﺎﻧﻲ ﺑﺴﻴﺎﺭ ﺑﻴﺸﺘﺮ ﺍﺯ ﺩﻳﺎﺳﺘﻮﻝ ﺑﻄﻨﻲ ﺍﺳﺖ‪ ،‬ﺗﻮﺍﻧﺎﻳﻲ ﺷﺮﻳﺎﻥﻫﺎ ﺩﺭ ﻣﺼﺮﻑ ﻭ ﺫﺧﻴﺮﻩ ﺍﻧﺮژﻱ‬
‫ﺩﺭ ﺩﻳﻮﺍﺭﻩ ﺍﻻﺳﺘﻴﻜﻲ ﺍﺳﺖ‪.‬‬

‫ﻓﺸﺎﺭ ﻧﺒﺾ‪:‬‬
‫ﻫﻨﮕﺎﻣﻲﻛﻪ ﺑﻄﻦ ﭼﭗ ﺧﻮﻥ ﺭﺍ ﺑﺎ ﺳﺮﻋﺖ ﺑﻪ ﺁﺋﻮﺭﺕ ﻣﻲﺭﻳﺰﺩ‪ ،‬ﻣﻮﺝ ﻓﺸﺎﺭ ﻳﺎ ﻧﺒﺾ ﺍﻳﺠﺎﺩ ﻣﻲﺷﻮﺩ‪ .‬ﺍﻳﻦ ﻣﻮﺝ ﺩﺭ ﺷﺮﻳﺎﻥﻫﺎﻱ‬
‫ﺩﺳﺘﮕﺎﻩ ﻗﻠﺐ ﻭ ﻋﺮﻭﻕ ﻣﻨﺘﻘﻞ ﺷﺪﻩ ﻭ ﺳﺮﻋﺖ ﺣﺮﻛﺖ ﺁﻥ ‪ 10‬ﺑﺮﺍﺑﺮ ﺑﻴﺸﺘﺮ ﺍﺯ ﺣﺮﻛﺖ ﺳﻠﻮﻝﻫﺎﻱ ﺧﻮﻧﻲ ﺍﺳﺖ‪ .‬ﺍﺧﺘﻼﻑ ﺑﻴﻦ‬
‫ﻓﺸﺎﺭ ﺳﻴﺴﺘﻮﻝ ﻭ ﺩﻳﺎﺳﺘﻮﻝ‪ ،‬ﻓﺸﺎﺭ ﻧﺒﺾ ﻧﺎﻣﻴﺪﻩ ﻣﻲﺷﻮﺩ‪.‬‬

‫‪۱‬‬
 ‫ﻓﺸﺎﺭ ﻣﺘﻮﺳﻂ ﺷﺮﻳﺎﻧﻲ‪:‬‬
‫ﻓﺸﺎﺭ ﺷﺮﻳﺎﻧﻲ ﻣﺘﻨﺎﻭﺏ ﺍﺳﺖ )ﺳﻴﺴﺘﻮﻝ ﻭ ﺩﻳﺎﺳﺘﻮﻝ( ﺍﻣﺎ ﻣﻲﺗﻮﺍﻥ ﺍﺯ ﻳﻚ ﻓﺸﺎﺭ ﻭﺍﺣﺪ ﺍﺳﺘﻔﺎﺩﻩ ﻧﻤﻮﺩ ﺑﻨﺎﻡ ﻓﺸﺎﺭ ﻣﺘﻮﺳﻂ‬
‫ﺷﺮﻳﺎﻧﻲ ﻛﻪ ﺍﺯ ﺭﺍﺑﻄﻪ ﺯﻳﺮ ﺑﺪﺳﺖ ﻣﻲﺁﻳﺪ‪:‬‬
‫)ﻓﺸﺎﺭ ﺩﻳﺎﺳﺘﻮﻟﻲ‪-‬ﻓﺸﺎﺭ ﺳﻴﺴﺘﻮﻟﻲ( ‪ +‬ﻓﺸﺎﺭ ﺩﻳﺎﺳﺘﻮﻟﻲ = ‪MAP‬‬
‫ﻣﺜﺎﻝ‪MAP=80+1/3(120-80) :‬‬
‫ﻓﺸﺎﺭ ﻣﺘﻮﺳﻂ ﺷﺮﻳﺎﻧﻲ ﺑﻪ ﻓﺸﺎﺭ ﺩﻳﺎﺳﺘﻮﻟﻲ ﻧﺰﺩﻳﻚﺗﺮ ﺍﺳﺖ ﭼﻮﻥ ﻣﺪﺕ ﺩﻳﺎﺳﺘﻮﻝ ﺩﻭ ﺑﺮﺍﺑﺮ ﺑﻴﺸﺘﺮ ﺍﺯ ﻣﺪﺕ ﺳﻴﺴﺘﻮﻝ ﺍﺳﺖ‪.‬‬
‫ﺍﻓﺰﺍﻳﺶ ﺿﺮﺑﺎﻥ ﻗﻠﺐ‪ ،‬ﺯﻣﺎﻥ ﺩﻳﺎﺳﺘﻮﻝ ﻗﻠﺒﻲ ﺭﺍ ﻛﻮﺗﺎﻩ ﻭ ﻓﺸﺎﺭ ﻣﺘﻮﺳﻂ ﺷﺮﻳﺎﻧﻲ ﺭﺍ ﺑﻪ ﻓﺸﺎﺭ ﺳﻴﺴﺘﻮﻝ ﻧﺰﺩﻳﻚﺗﺮ ﻣﻲﻛﻨﺪ‪.‬‬
‫ﺍﻧﺪﺍﺯﻩﮔﻴﺮﻱ ﻓﺸﺎﺭ ﺧﻮﻥ‪:‬‬
‫ﺑﻄﻮﺭ ﻣﻌﻤﻮﻝ ﻓﺸﺎﺭ ﺍﺯ ﺷﺮﻳﺎﻥ ﺭﺍﺩﻳﺎﻝ ﺑﺎ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ‬
‫)‪ sphygmomanometer (sphygmus plus + monometer‬ﺍﻧﺪﺍﺯﻩﮔﻴﺮﻱ ﻣﻲﺷﻮﺩ‪ .‬ﻣﺎﻧﻮﻣﺘﺮ ﺍﺑﺰﺍﺭﻱ ﺑﺮﺍﻱ‬
‫ﺍﻧﺪﺍﺯﻩﮔﻴﺮﻱ ﻓﺸﺎﺭ ﻣﺎﻳﻌﺎﺕ ﺍﺳﺖ‪.‬‬
‫ﺁﺯﻣﺎﻳﺶ ﺍﻭﻝ‪ :‬ﺍﻧﺪﺍﺯﻩﮔﻴﺮﻱ ﻓﺸﺎﺭﺧﻮﻥ ﺷﺮﻳﺎﻧﻲ‬
‫ﻭﺳﺎﻳﻞ ﻣﻮﺭﺩ ﻧﻴﺎﺯ‪:‬‬
‫‪ -1‬ﺩﺳﺘﮕﺎﻩ ﺍﻧﺪﺍﺯﻩﮔﻴﺮﻱ ﻓﺸﺎﺭﺧﻮﻥ ﺍﺳﻔﻴﮕﻤﻮﻣﺎﻧﻮﻣﺘﺮ )‪(sphygmomanometer‬‬
‫ﺍﻟﻒ( ﺑﺎﺯﻭﺑﻨﺪ ﻗﺎﺑﻞ ﺑﺎﺩ ﺷﺪﻥ ﺑﺮﺍﻱ ﺑﺴﺘﻦ ﺩﺭ ﻣﺤﻞ ﺷﺮﻳﺎﻥ ﻣﻮﺭﺩ ﺁﺯﻣﺎﻳﺶ ﻛﻪ ﻗﺎﺑﻠﻴﺖ ﺍﺗﺴﺎﻉ ﺁﻥ ﺑﻮﺳﻴﻠﻪ ﭘﺎﺭﭼﻪﺍﻱ ﻣﺤﺪﻭﺩ‬
‫ﺷﺪﻩ ﺍﺳﺖ‪.‬‬
‫ﺏ( ﭘﻤﭗ ﻛﻮﭼﻚ ﺑﺮﺍﻱ ﺑﺎﺩ ﻛﺮﺩﻥ ﺑﺎﺯﻭﺑﻨﺪ‬
‫ﺝ( ﻟﻮﻟﻪ ﺍﺗﺼﺎﻝ ﺩﻫﻨﺪﻩ ﭘﻤﭗ ﺑﺎ ﺑﺎﺯﻭﺑﻨﺪ‬
‫ﺩ( ﻣﺎﻧﻮﻣﺘﺮ ﺟﻴﻮﻩﺍﻱ ﻳﺎ ﻓﻨﺮﻱ ﻳﺎ ﺍﻟﻜﺘﺮﻳﻜﻲ ﻛﻪ ﻓﺸﺎﺭ ﺩﺍﺧﻞ ﺑﺎﺯﻭﺑﻨﺪ ﺭﺍ ﻣﺸﺨﺺ ﻣﻲ ﻛﻨﺪ ﻭ ﺻﻔﺮ ﺁﻥ ﺑﺮﺍﺑﺮ ﺻﻔﺮ ﺟﻮ ﺍﺳﺖ‪.‬‬
‫‪ -2‬ﮔﻮﺷﻲ ﭘﺰﺷﻜﻲ ﻳﺎ ‪stethoscope‬‬
‫ﺍﻟﻒ( ﺑﻞ ﻭ ﺩﻳﺎﻓﺮﺍﮔﻢ ﺑﺮﺍﻱ ﮔﺬﺍﺷﺘﻦ ﺭﻭﻱ ﺷﺮﻳﺎﻥ ﻣﻮﺭﺩ ﻧﻈﺮ‬
‫ﺏ(ﮔﻮﺷﻲ ﻛﻪ ﺩﺭ ﮔﻮﺵ ﻗﺮﺍﺭ ﻣﻲ ﮔﻴﺮﺩ‬
‫ﺝ( ﻟﻮﻟﻪﻫﺎﻱ ﺍﺗﺼﺎﻝ ﺩﻫﻨﺪﻩ ﺑﻞ ﻭ ﺩﻳﺎﻓﺮﺍﮔﻢ ﺑﻪ ﮔﻮﺷﻲ‬
‫ﻻﺯﻡ ﺑﻪ ﻳﺎﺩﺁﻭﺭﻱ ﺍﺳﺖ ﻛﻪ‪:‬‬
‫‪ -‬ﻋﺒﻮﺭ ﺧﻮﻥ ﺍﺯ ﻋﺮﻭﻕ ﻃﺒﻴﻌﻲ ﻓﺎﻗﺪ ﺻﺪﺍﺳﺖ‪.‬‬
‫‪ -‬ﻣﺴﺪﻭﺩ ﺷﺪﻥ ﻗﺴﻤﺘﻲ ﺍﺯ ﻣﺤﻴﻂ ﺷﺮﻳﺎﻥ ﺑﻮﺳﻴﻠﻪ ﺑﺎﺯﻭﺑﻨﺪ ﻓﺸﺎﺭﻱ ﻭ ﻳﺎ ﻋﻮﺍﻣﻞ ﺩﻳﮕﺮ ﺑﺎﻋﺚ ﺍﻳﺠﺎﺩ ﺻﺪﺍ ﻣﻲﮔﺮﺩﺩ‪.‬‬
‫‪ -‬ﻗﻄﻊ ﺗﻤﺎﻣﻲ ﺟﺮﻳﺎﻥ ﺧﻮﻥ ﺩﺭ ﺷﺮﻳﺎﻥ ﺑﺎﻋﺚ ﺍﺯ ﺑﻴﻦ ﺭﻓﺘﻦ ﻫﺮﮔﻮﻧﻪ ﺻﺪﺍﻳﻲ ﻣﻲﮔﺮﺩﺩ‪.‬‬

‫ﺭﻭﺵﻫﺎﻱ ﺍﻧﺪﺍﺯﻩﮔﻴﺮﻱ ﻓﺸﺎﺭ ﺧﻮﻥ‬

‫ﺍﻟﻒ‪ :‬ﺗﻌﻴﻴﻦ ﻓﺸﺎﺭﺧﻮﻥ ﺗﻮﺳﻂ ﻧﺒﺾ ﻳﺎ ﺭﻭﺵ ﻟﻤﺴﻲ )‪(palpation method‬‬
‫ﺑﺎﺯﻭﺑﻨﺪ ﺭﺍ ﺑﻄﻮﺭ ﻣﺤﻜﻢ ﻭﻟﻲ ﻧﻪ ﺳﻔﺖ ﺩﻭﺭ ﺑﺎﺯﻭ ﻣﻲﺑﻨﺪﻳﻢ‪ ،‬ﺑﻄﻮﺭﻱ ﻛﻪ ﺑﻴﻦ ﺣﺪ ﺗﺤﺘﺎﻧﻲ ﻛﻴﺴﻪ ﺑﺎﺯﻭﺑﻨﺪ ﻭ ﭼﻴﻦ ﺁﺭﻧﺞ ‪2-3‬‬
‫ﺳﺎﻧﺘﻴﻤﺘﺮ ﻓﺎﺻﻠﻪ ﻭﺟﻮﺩ ﺩﺍﺷﺘﻪ ﺑﺎﺷﺪ‪ .‬ﺁﻧﮕﺎﻩ ﻧﺒﺾ ﺷﺮﻳﺎﻥ ﺯﻧﺪ ﺯﺑﺮﻳﻦ )‪ (radial‬ﺭﺍ ﺩﺭ ﻣﭻ ﺩﺳﺖ ﺣﺲ ﻣﻲﻛﻨﻴﻢ ﻭ ﺩﺭ‬
‫ﺣﺎﻟﻴﻜﻪ ﺑﺎ ﺍﻧﮕﺸﺘﺎﻥ ﻳﻚ ﺩﺳﺖ ﻧﺒﺾ ﺭﺍ ﻛﻨﺘﺮﻝ ﻣﻲﻧﻤﺎﺋﻴﻢ‪ ،‬ﺑﺎ ﺩﺳﺖ ﺩﻳﮕﺮ ﭘﻴﭻ ﭘﻤﭗ ﺩﺳﺘﻲ ﺭﺍ ﺑﺴﺘﻪ ﻭ ﺑﺎ ﭘﻤﭙﺎژ ﺁﻥ ﻛﻴﺴﻪ‬

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‫ﺑﺎﺯﻭﺑﻨﺪ ﺭﺍ ﺑﺎﺯ ﻣﻲﻛﻨﻴﻢ‪ .‬ﻓﺸﺎﺭ ﺩﺍﺧﻞ ﺁﻥ ﺍﺯ ﻓﺸﺎﺭ ﺷﺮﻳﺎﻧﻲ ﺑﻴﺸﺘﺮ ﺷﺪﻩ ﻭ ﺟﺮﻳﺎﻥ ﺧﻮﻥ ﻗﻄﻊ ﻣﻲﺷﻮﺩ‪ .‬ﺩﺭ ﺍﻳﻦ ﺯﻣﺎﻥ ﻛﻪ ﻧﺒﺾ‬
‫ﻗﻄﻊ ﻣﻲﺷﻮﺩ ﺑﻪ ﻓﺸﺎﺭ ﻧﺸﺎﻥ ﺩﺍﺩﻩ ﺷﺪﻩ ﺭﻭﻱ ﻣﺎﻧﻮﻣﺘﺮ ﺩﻗﺖ ﻛﺮﺩﻩ ﻭ ﺣﺪﺍﻛﺜﺮ ‪ 30‬ﻣﻴﻠﻲﻣﺘﺮ ﺟﻴﻮﻩ ﺑﻴﺸﺘﺮ ﺍﺯ ﻓﺸﺎﺭ ﻧﺸﺎﻥ ﺩﺍﺩﻩ‬
‫ﺷﺪﻩ‪ ،‬ﻓﺸﺎﺭ ﺳﻨﺞ ﺭﺍ ﭘﻤﭗ ﻣﻲﻛﻨﻴﻢ‪ .‬ﺳﭙﺲ ﭘﻤﭗ ﺩﺳﺘﻲ ﺭﺍ ﻛﻤﻲ ﺑﺎﺯ ﻣﻲﻛﻨﻴﻢ ﻭ ﺍﺟﺎﺯﻩ ﻣﻲﺩﻫﻴﻢ ﺗﺎ ﻓﺸﺎﺭ ﺑﺎﺯﻭﺑﻨﺪ ﺑﺘﺪﺭﻳﺞ‬
‫ﻛﻢ ﺷﻮﺩ‪ .‬ﺩﺭ ﺍﻳﻦ ﺣﺎﻝ ﺑﺎﻳﺪ ﻣﺤﻞ ﻧﺒﺾ ﺭﺍ ﻛﻨﺘﺮﻝ ﻭ ﻣﺎﻧﻮﻣﺘﺮ ﻓﺸﺎﺭﺳﻨﺞ ﺭﺍ ﺑﻪ ﺩﻗﺖ ﺗﺤﺖ ﻧﻈﺮ ﺩﺍﺷﺘﻪ ﺑﺎﺷﻴﻢ‪ .‬ﺩﺭﺟﻪ ﺍﻱ ﻛﻪ‬
‫ﺍﻭﻟﻴﻦ ﻣﻮﺝ ﻧﺒﺾ ﺭﺍ ﻟﻤﺲ ﻣﻲﻛﻨﻴﻢ‪ ،‬ﺑﺮﺍﺑﺮ ﺑﺎ ﻓﺸﺎﺭ ﺳﻴﺴﺘﻮﻟﻴﻚ ﺍﺳﺖ‪ .‬ﺑﺮﺍﻱ ﻛﻨﺘﺮﻝ ﻧﺒﺾ ﻧﺒﺎﻳﺪ ﺍﺯ ﺍﻧﮕﺸﺖ ﺷﺴﺖ ﺍﺳﺘﻔﺎﺩﻩ‬
‫ﻛﺮﺩ‪ ،‬ﺯﻳﺮﺍ ﺍﻧﮕﺸﺖ ﺷﺴﺖ ﺧﻮﺩ ﺩﺍﺭﺍﻱ ﻧﺒﺾ ﺍﺳﺖ‪.‬‬
‫ﺗﻮﺟﻪ‪ :‬ﺩﺭ ﺍﻳﻦ ﺭﻭﺵ ﻓﻘﻂ ﻓﺸﺎﺭ ﺳﻴﺴﺘﻮﻟﻴﻚ ﻗﺎﺑﻞ ﺍﻧﺪﺍﺯﻩﮔﻴﺮﻱ ﺍﺳﺖ‪.‬‬
‫ﺏ‪ :‬ﺗﻌﻴﻴﻦ ﻓﺸﺎﺭﺧﻮﻥ ﺑﻪ ﺭﻭﺵ ﺳﻤﻌﻲ )‪ (auscultator method‬ﻭ ﺷﻨﻴﺪﻥ ﺻﺪﺍﻫﺎﻱ ﻛﻮﺭﺗﻜﻮﻑ‬
‫ﺑﺎﺯﻭﺑﻨﺪ ﺭﺍ ﻣﺜﻞ ﺁﺯﻣﺎﻳﺶ ﻗﺒﻞ ﺩﻭﺭ ﺑﺎﺯﻭ ﻣﻲ ﺑﻨﺪﻳﻢ‪ .‬ﻣﺤﻞ ﻧﺒﺾ ﺑﺎﺯﻭﻳﻲ ﺭﺍ ﺑﺎ ﻟﻤﺲ ﺩﺭ ﻗﺴﻤﺖ ﺩﺍﺧﻠﻲ ﺧﻢ ﺁﺭﻧﺞ ﻣﺸﺨﺺ‬
‫ﻣﻲﻛﻨﻴﻢ‪ .‬ﺩﻳﺎﻓﺮﺍﮔﻢ ﺍﺳﺘﺘﻮﺳﻜﻮپ )ﮔﻮﺷﻲ( ﺭﺍ ﺩﺭ ﻣﺤﻞ ﺁﻥ ﻗﺮﺍﺭ ﺩﺍﺩﻩ‪ ،‬ﺩﻗﺖ ﺷﻮﺩ ﻛﻪ ﺻﻔﺤﻪ ﺩﻳﺎﻓﺮﺍﮔﻢ ﮔﻮﺷﻲ ﺯﻳﺮ ﺑﺎﺯﻭﺑﻨﺪ‬
‫ﻓﺸﺎﺭ ﺳﻨﺞ ﻗﺮﺍﺭ ﻧﮕﻴﺮﺩ ﻭ ﺑﺎﺯﻭﺑﻨﺪ ﻓﺸﺎﺭ ﺳﻨﺞ ﺑﺎﻻﺗﺮ ﺍﺯ ﺁﻥ ﺑﺴﺘﻪ ﺷﻮﺩ ﺳﭙﺲ ﺑﺎ ﺑﺎﺩ ﻛﺮﺩﻥ ﺑﺎﺯﻭﺑﻨﺪ ﻓﺸﺎﺭ ﺩﺍﺧﻞ ﺁﻥ ﺭﺍ ﺑﺎﻻ‬
‫ﻣﻲﺑﺮﻳﻢ )ﺣﺪﺍﻛﺜﺮ ‪ 30‬ﻣﻴﻠﻲﻣﺘﺮ ﺟﻴﻮﻩ ﺑﺎﻻﺗﺮ ﺍﺯ ﻗﻄﻊ ﻧﺒﺾ ﻛﻪ ﺑﻪ ﻃﺮﻳﻖ ﻟﻤﺴﻲ ﮔﺮﻓﺘﻪ ﺷﺪﻩ ﺍﺳﺖ( ﺗﺎ ﺟﺮﻳﺎﻥ ﺧﻮﻥ ﻗﻄﻊ‬
‫ﮔﺮﺩﺩ‪ .‬ﺳﭙﺲ ﺩﺭﻳﭽﻪ ﺧﺮﻭﺝ ﻫﻮﺍ )ﭘﻴﭻ ﭘﻤﭗ ﺩﺳﺘﻲ(ﺭﺍ ﺑﻪ ﺁﺭﺍﻣﻲ ﺑﺎﺯ ﻣﻲ ﻛﻨﻴﻢ ﺗﺎ ﻓﺸﺎﺭ ﻛﻴﺴﻪ ﺑﺎﺯﻭﺑﻨﺪ ﺑﺮﺍﺑﺮ ﻓﺸﺎﺭ‬
‫ﺳﻴﺴﺘﻮﻟﻴﻚ ﺷﻮﺩ‪ .‬ﺩﺭ ﺍﻳﻦ ﻣﺮﺣﻠﻪ ﺻﺪﺍﻳﻲ ﺷﻨﻴﺪﻩ ﻣﻲ ﺷﻮﺩ ﻛﻪ ﺑﻪ ﺍﻓﺘﺨﺎﺭ ﻛﺎﺷﻒ ﺁﻥ‪ ،‬ﻛﻮﺭﺗﻜﻮﻑ ﻧﺎﻣﻴﺪﻩ ﻣﻲ ﺷﻮﺩ‪ .‬ﺍﻳﻦ ﺻﺪﺍ‬
‫ﺑﻪ ﺩﻟﻴﻞ ﺟﺮﻳﺎﻥ ﺗﻮﺭﺑﻮﻻﻧﺖ ﻧﺎﺷﻲ ﺍﺯﺍﻧﺴﺪﺍﺩ ﺗﻮﺳﻂ ﺑﺎﺯﻭﺑﻨﺪ ﻓﺸﺎﺭﺳﻨﺞ ﺍﺳﺖ ﻛﻪ ﺑﻪ ﺗﺪﻳﺞ ﺑﻠﻨﺪ ﺗﺮ ﻣﻲ ﺷﻮﺩ ﺗﺎ ﻧﻬﺎﻳﺘﺎ ﻗﻄﻊ‬
‫ﺷﻮﺩ‪.‬‬
‫ﻫﻨﮕﺎﻣﻲ ﻛﻪ ﺍﻭﻟﻴﻦ ﺻﺪﺍﻱ ﻛﻮﺭﻭﺗﻜﻮﻑ ﻛﻪ ﻣﻌﻤﻮﻻ ﺿﻌﻴﻒ ﺍﺳﺖ ﻭ ﺑﻪ ﮔﻮﺵ ﺭﺳﻴﺪ‪ ،‬ﻓﺸﺎﺭ ﻣﺎﻧﻮﻣﺘﺮ ﺩﺳﺘﮕﺎﻩ ﺭﺍ ﻳﺎﺩﺩﺍﺷﺖ‬
‫ﻣﻲﻛﻨﻴﻢ‪ .‬ﺍﻳﻦ ﻓﺸﺎﺭ ﺑﺮﺍﺑﺮ ﺑﺎ ﻓﺸﺎﺭ ﺳﻴﺴﺘﻮﻟﻴﻚ ﺍﺳﺖ‪ .‬ﺳﭙﺲ ﺑﻪ ﺧﺎﺭﺝ ﻛﺮﺩﻥ ﻫﻮﺍﻱ ﺑﺎﺯﻭﺑﻨﺪ ﺍﺩﺍﻣﻪ ﻣﻲ ﺩﻫﻴﻢ‪ .‬ﺑﺘﺪﺭﻳﺞ ﻛﻪ‬
‫ﻓﺸﺎﺭ ﺩﺍﺧﻞ ﺑﺎﺯﻭﺑﻨﺪ ﻛﻢ ﻣﻲﺷﻮﺩ‪ ،‬ﺻﺪﺍﻫﺎﻱ ﻛﻮﺭﺗﻜﻮﻑ ﻗﻮﻳﺘﺮ ﻭ ﻗﻮﻳﺘﺮ ﻣﻲﺷﻮﻧﺪ )ﺑﻪ ﻋﻠﺖ ﻭﺭﻭﺩ ﻣﻘﺪﺍﺭ ﺑﻴﺸﺘﺮ ﺧﻮﻥ ﺩﺭ ﻫﺮ‬
‫ﺩﻭﺭﻩ ﺗﻨﺎﻭﺏ(‪ .‬ﺯﻣﺎﻧﻲ ﻛﻪ ﻓﺸﺎﺭ ﺩﺍﺧﻞ ﺑﺎﺯﻭﺑﻨﺪ ﻣﺴﺎﻭﻱ ﻓﺸﺎﺭ ﺩﻳﺎﺳﺘﻮﻟﻴﻚ ﺷﻮﺩ‪ ،‬ﺻﺪﺍﻫﺎ ﻳﻜﺒﺎﺭﻩ ﮔﻨﮓ ﻭ ﺧﻔﻪ ﻣﻲﺷﻮﻧﺪ ﻭ ﺩﺭ‬
‫ﻓﺸﺎﺭ ﺍﻧﺪﻛﻲ ﭘﺎﺋﻴﻦﺗﺮ‪ ،‬ﺻﺪﺍﻫﺎ ﺍﺯ ﺑﻴﻦ ﻣﻲﺭﻭﻧﺪ‪ .‬ﻓﺸﺎﺭ ﻣﺎﻧﻮﻣﺘﺮ ﺭﺍ ﺑﻪ ﻫﻨﮕﺎﻡ ﺍﺯ ﺑﻴﻦ ﺭﻓﺘﻦ ﺻﺪﺍﻫﺎ ﺑﻌﻨﻮﺍﻥ ﻓﺸﺎﺭ ﺩﻳﺎﺳﺘﻮﻟﻴﻚ‬
‫ﻳﺎﺩﺩﺍﺷﺖ ﻣﻲﻛﻨﻴﻢ‪.‬‬

‫ﺷﺮﺍﻳﻂ ﺁﺯﻣﺎﻳﺶ ﻭ ﻧﻜﺎﺗﻲ ﻛﻪ ﺩﺭ ﺗﻌﻴﻴﻦ ﻓﺸﺎﺭﺧﻮﻥ ﺷﺮﻳﺎﻧﻲ ﺑﺎﻳﺪ ﺩﺭ ﻧﻈﺮ ﺩﺍﺷﺖ‪:‬‬

‫‪ -‬ﺷﺨﺺ ﻣﻮﺭﺩ ﺁﺯﻣﺎﻳﺶ ﺑﺎﻳﺪ ﺩﺭ ﺍﺳﺘﺮﺍﺣﺖ ﻛﺎﻣﻞ ﺭﻭﺣﻲ ﻭ ﺟﺴﻤﻲ ﺑﺎﺷﺪ ﻭ ﻳﻚ ﺭﺑﻊ ﻗﺒﻞ ﺍﺯ ﺍﻧﺠﺎﻡ ﺁﺯﻣﺎﻳﺶ ﺑﺮ ﺭﻭﻱ‬ ‫‪1‬‬
‫ﺗﺨﺖ ﺑﺨﻮﺍﺑﺪ ﻳﺎ ﺭﻭﻱ ﺻﻨﺪﻟﻲ ﺩﺭ ﺣﺎﻝ ﺍﺳﺘﺮﺍﺣﺖ ﻛﺎﻣﻞ ﺑﻨﺸﻴﻨﺪ‪ .‬ﺿﻤﻨﺎً ﺑﻼﻓﺎﺻﻠﻪ ﺑﻌﺪ ﺍﺯ ﺧﻮﺭﺩﻥ ﻏﺬﺍ ﻧﺒﺎﺷﺪ‪.‬‬
‫‪ -‬ﺍﮔﺮ ﺑﺮﺍﻱ ﻣﺪﺗﻲ ﺑﺎﺯﻭﺑﻨﺪ ﻓﺸﺎﺭ )ﺩﺭ ﺣﺎﻟﻲ ﻛﻪ ﭘﺮ ﺍﺯ ﻫﻮﺍ ﺷﺪﻩ ﺍﺳﺖ( ﺑﺮ ﺭﻭﻱ ﺑﺎﺯﻭﻱ ﺷﺨﺺ ﺑﺴﺘﻪ ﺑﻤﺎﻧﺪ‪ ،‬ﺍﻳﺠﺎﺩ‬ ‫‪2‬‬
‫ﻧﺎﺭﺍﺣﺘﻲ ﻛﺮﺩﻩ ﻭ ﺍﻳﻦ ﻋﻤﻞ ﻣﻤﻜﻦ ﺍﺳﺖ ﺑﻄﻮﺭ ﺭﻓﻠﻜﺴﻲ ﻣﻮﺟﺐ ﺗﻨﮓ ﺷﺪﻥ ﻋﻤﻮﻣﻲ ﻋﺮﻭﻕ‬
‫)‪ (Generalized vasoconstriction‬ﺷﺪﻩ ﻭ ﻓﺸﺎﺭﺧﻮﻥ ﺭﺍ ﺑﺎﻻ ﺑﺒﺮﺩ‪.‬‬
‫‪ -‬ﻫﻤﻴﺸﻪ ﺑﻬﺘﺮ ﺍﺳﺖ ﻛﻪ ﺑﺮﺍﻱ ﻣﻘﺎﻳﺴﻪ‪ ،‬ﻓﺸﺎﺭﺧﻮﻥ ﺭﺍ ﺩﺭ ﻫﺮ ﺩﻭ ﺑﺎﺯﻭ ﺍﻧﺪﺍﺯﻩﮔﻴﺮﻱ ﻛﺮﺩ‪ ،‬ﺑﺨﺼﻮﺹ ﺩﺭ ﻓﺮﺩﻱ ﻛﻪ ﺑﺮﺍﻱ‬ ‫‪3‬‬
‫ﺍﻭﻟﻴﻦ ﺑﺎﺭ ﻓﺸﺎﺭﺧﻮﻥ ﻭﻱ ﺍﻧﺪﺍﺯﻩﮔﻴﺮﻱ ﻣﻲﺷﻮﺩ‪ ،‬ﭼﻨﺎﻧﻜﻪ ﭘﻴﻮﺳﺘﻪ ﺗﻐﻴﻴﺮ ﻗﺎﺑﻞ ﻣﻼﺣﻈﻪﺍﻱ ﺩﺭ ﻓﺸﺎﺭ ﺧﻮﻥ ﺷﺮﻳﺎﻧﻲ ﺩﻭ‬
‫ﺑﺎﺯﻭ ﺑﻪ ﭼﺸﻢ ﺑﺨﻮﺭﺩ ﻧﺸﺎﻥﺩﻫﻨﺪﻩ ﻭﺟﻮﺩ ﺍﻧﺴﺪﺍﺩ ﻋﺮﻭﻗﻲ ﺍﺳﺖ‪.‬‬
‫‪ -‬ﺑﺮﺍﻱ ﺟﻠﻮﮔﻴﺮﻱ ﺍﺯ ﺗﺎﺛﻴﺮ ﻧﻴﺮﻭﻱ ﺛﻘﻞ ﺑﺎﻳﺪ ﺑﺎﺯﻭﺑﻨﺪ ﻫﻢﺳﻄﺢ ﻗﻠﺐ ﺑﺎﺷﺪ ﺗﺎ ﺷﺮﻳﺎﻥ ﺑﺮﺍﻛﻴﺎﻝ ﻧﻴﺰ ﺩﺭ ﻫﻤﺎﻥ ﺳﻄﺢ‬ ‫‪4‬‬
‫ﻣﻮﺭﺩ ﺁﺯﻣﺎﻳﺶ ﻗﺮﺍﺭ ﮔﻴﺮﺩ‪.‬‬

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‫ﻓﺸﺎﺭﺧﻮﻥ ﺑﻪ ﺍﺯﺍﻱ ﻫﺮ ‪ 12‬ﺳﺎﻧﺘﻴﻤﺘﺮ ﺩﺭ ﺯﻳﺮ ﺳﻄﺢ ﻗﻠﺐ ﺑﻪ ﻋﻠﺖ ﺍﻓﺰﺍﻳﺶ ﻧﻴﺮﻭﻱ ﺛﻘﻞ ‪ 10‬ﻣﻴﻠﻴﻤﺘﺮ ﺟﻴﻮﻩ ﺍﺿﺎﻓﻪ ﻭ ﺩﺭ ﺑﺎﻻﻱ‬
‫ﺳﻄﺢ ﻗﻠﺐ ﺑﻪ ﻫﻤﻴﻦ ﻧﺴﺒﺖ ﻛﻢ ﻣﻲﺷﻮﺩ‪ .‬ﺑﻪ ﺍﻳﻦ ﺗﺮﺗﻴﺐ ﺩﺭ ﻭﺿﻌﻴﺖ ﺍﻳﺴﺘﺎﺩﻩ ﻓﺸﺎﺭ ﺩﺭ ﭘﺎ ‪ 210‬ﻣﻴﻠﻴﻤﺘﺮ ﺟﻴﻮﻩ ﻭ ﺩﺭ ﺳﺮ‬
‫ﻓﻘﻂ ‪ 90‬ﻣﻴﻠﻴﻤﺘﺮ ﺟﻴﻮﻩ ﺧﻮﺍﻫﺪ ﺑﻮﺩ‪ .‬ﻭﻟﻲ ﺩﺭ ﻭﺿﻌﻴﺖ ﺩﺭﺍﺯﻛﺶ ﺍﻳﻦ ﺩﻭ ﻓﺸﺎﺭ ﺑﺎ ﻫﻢ ﺑﺮﺍﺑﺮ ﺑﻮﺩﻩ ﻭ ﻣﻌﺎﺩﻝ ‪ 120‬ﻣﻴﻠﻴﻤﺘﺮ‬
‫ﺟﻴﻮﻩ ﺍﺳﺖ‪ .‬ﺑﻪ ﻫﻤﻴﻦ ﺩﻟﻴﻞ ﺑﻪ ﻫﻨﮕﺎﻡ ﮔﺮﻓﺘﻦ ﻓﺸﺎﺭ‪ ،‬ﺷﺮﻳﺎﻥ ﻣﻮﺭﺩ ﻧﻈﺮ ﺑﺎﻳﺪ ﻫﻢﺳﻄﺢ ﻗﻠﺐ ﺑﺎﺷﺪ‪.‬‬
‫ﺍﻣﺮﻭﺯﻩ ﻓﺸﺎﺭﺳﻨﺞﻫﺎﻳﻲ ﺳﺎﺧﺘﻪ ﺷﺪﻩ ﻛﻪ ﺑﺎ ﺑﺴﺘﻦ ﺑﻪ ﺑﺎﺯﻭ ﻳﺎ ﻣﭻ‪ ،‬ﻓﺸﺎﺭ ﺳﻴﺴﺘﻮﻟﻲ ﻭ ﻓﺸﺎﺭ ﺩﻳﺎﺳﺘﻮﻟﻲ ﻭ ﻧﺒﺾ ﺭﺍ ﺑﺼﻮﺭﺕ‬
‫ﺩﻳﺠﻴﺘﺎﻟﻲ ﮔﺰﺍﺭﺵ ﻣﻲ ﻛﻨﻨﺪ ﻛﻪ ﺑﻪ ﻋﻠﺖ ﻋﺪﻡ ﺍﺷﺘﺒﺎﻩ ﺩﺭ ﺗﺸﺨﻴﺺ ﺻﺪﺍ ﺗﻮﺳﻂ ﮔﻮﺵ‪ ،‬ﺧﻄﺎﻱ ﺁﻧﻬﺎ ﻛﻤﺘﺮ ﺍﺳﺖ‪ .‬ﻃﺮﺯ ﻛﺎﺭ‬
‫ﺍﻳﻦ ﺩﺳﺘﮕﺎﻩﻫﺎ ﺭﺍ ﺑﺎ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﻛﺎﺗﺎﻟﻮگ ﺁﻧﻬﺎ ﻣﻲﺗﻮﺍﻥ ﻳﺎﺩ ﮔﺮﻓﺖ‪.‬‬
‫ﺩﺭ ﺍﺩﺍﻣﻪ ﺁﺯﻣﺎﻳﺶﻫﺎﻱ ﺯﻳﺮ ﺭﺍ ﺍﻧﺠﺎﻡ ﺩﻫﻴﺪ‪.‬‬
‫‪ - 1‬ﺩﺭ ﺣﺎﻟﺖ ﻧﺸﺴﺘﻪ‪ ،‬ﺧﻮﺍﺑﻴﺪﻩ ﻭ ﺍﻳﺴﺘﺎﺩﻩ ﻓﺸﺎﺭﺧﻮﻥ ﺭﺍ ﺑﺎ ﺩﻭ ﺭﻭﺵ ﻓﻮﻕ ﺑﺮﺭﺳﻲ ﻧﻤﺎﺋﻴﺪ‪.‬‬
‫‪ 20 - 2‬ﺑﺎﺭ ﺑﻨﺸﻴﻨﻴﺪ ﻭ ﺑﻠﻨﺪ ﺷﻮﻳﺪ ﻭ ﺳﭙﺲ ﻓﺸﺎﺭ ﺧﻮﻥ ﻭ ﺿﺮﺑﺎﻥ ﻗﻠﺐ ﺭﺍ ﺍﻧﺪﺍﺯﻩﮔﻴﺮﻱ ﻛﻨﻴﺪ‪.‬‬
‫‪ 5 - 3‬ﺩﻗﻴﻘﻪ ﺑﻌﺪ ﺍﺯ ﻣﺮﺣﻠﻪ ‪ 2‬ﺩﻭﺑﺎﺭﻩ ﻓﺸﺎﺭﺧﻮﻥ ﻭﺿﺮﺑﺎﻥ ﻗﻠﺐ ﺭﺍ ﺍﻧﺪﺍﺯﻩﮔﻴﺮﻱ ﻛﻨﻴﺪ‪.‬‬

‫ﻋﻮﺍﻣﻠﻲ ﻛﻪ ﺑﺮ ﺭﻭﻱ ﻓﺸﺎﺭﺧﻮﻥ ﻣﻮﺛﺮﻧﺪ‪:‬‬

‫ﺍﻟﻒ( ﻋﻮﺍﻣﻞ ﻓﻴﺰﻳﻮﻟﻮژﻳﻜﻲ‬
‫‪ - 1‬ﺳﻦ‪ :‬ﻗﺎﺑﻠﻴﺖ ﺍﺭﺗﺠﺎﻋﻲ ﺟﺪﺍﺭ ﺭگﻫﺎ ﺑﺎ ﺍﻓﺰﺍﻳﺶ ﺳﻦ ﻛﺎﻫﺶ ﻣﻲﻳﺎﺑﺪ‪ .‬ﻟﺬﺍ ﺑﺎ ﺍﻓﺰﺍﻳﺶ ﺳﻦ ﻓﺸﺎﺭ ﺧﻮﻥ ﺍﻓﺰﺍﻳﺶ‬
‫ﻣﻲﻳﺎﺑﺪ‪.‬‬
‫‪ - 2‬ﻭﺯﻥ‬
‫‪ - 3‬ﺍﺳﺘﺮﺱ‬
‫ﺏ( ﻋﻮﺍﻣﻞ ﻓﻴﺰﻳﻜﻲ‬
‫ﺍﻳﻦ ﻋﻮﺍﻣﻞ ﻋﺒﺎﺭﺗﻨﺪ ﺍﺯ ﺗﻌﺪﺍﺩ ﺿﺮﺑﺎﻧﺎﺕ ﻗﻠﺐ‪ ،‬ﻭﻳﺴﻜﻮﺯﻳﺘﻪ ﺧﻮﻥ‪ ،‬ﻗﺎﺑﻠﻴﺖ ﺍﺭﺗﺠﺎﻋﻲ ﺭگﻫﺎ‪ ،‬ﻣﻘﺎﻭﻣﺖ ﻣﺤﻴﻄﻲ‬
‫ﺑﺮﺍﻱ ﺍﺛﺒﺎﺕ ﻏﻴﺮﻃﺒﻴﻌﻲ ﺑﻮﺩﻥ ﻓﺸﺎﺭﺧﻮﻥ )ﺑﺎﻻﺗﺮ ﺑﻮﺩﻥ ﺁﻥ ﺍﺯ ﺣﺎﻟﺖ ﻃﺒﻴﻌﻲ( ﺑﺎﻳﺴﺘﻲ ﺣﺪﺍﻗﻞ ﺩﺭ ﺩﻭ ﻧﻮﺑﺖ )ﺗﺮﺟﻴﺤﺎً ﺩﺭ ﻳﻚ‬
‫ﺯﻣﺎﻥ ﻣﺸﺨﺺ ﺍﺯ ﺭﻭﺯ( ﺑﻪ ﻓﺎﺻﻠﻪ ‪ 2-4‬ﻫﻔﺘﻪ ﻭ ﺩﺭ ﻫﺮ ﻧﻮﺑﺖ ‪ 2‬ﺑﺎﺭ ﺑﻪ ﻓﺎﺻﻠﻪ ﺣﺪﺍﻗﻞ ‪ 2‬ﺩﻗﻴﻘﻪ ﻓﺸﺎﺭﺧﻮﻥ ﺑﺎﻻ ﺑﺎﺷﺪ‪ .‬ﻣﻄﺎﺑﻖ‬
‫ﺁﻣﺎﺭ ﺣﺪﻭﺩ ‪ 20‬ﺩﺭﺻﺪ ﺍﻓﺮﺍﺩ ﺑﺎﻻﻱ ‪ 18‬ﺳﺎﻝ ﻓﺸﺎﺭﺧﻮﻥ ﺑﺎﻻﺗﺮ ﺍﺯ ﻃﺒﻴﻌﻲ ﺩﺍﺭﻧﺪ‪.‬‬

‫ﺳﻴﺴﺘﻢﻫﺎﻱ ﺗﻨﻈﻴﻢ ﻛﻨﻨﺪﻩ ﻓﺸﺎﺭ ﺷﺮﻳﺎﻧﻲ‪:‬‬

‫ﺑﺎ ﻭﺟﻮﺩ ﻋﻮﺍﻣﻠﻲ ﻛﻪ ﺑﺮ ﺭﻭﻱ ﻓﺸﺎﺭﺧﻮﻥ ﺗﺎﺛﻴﺮ ﻣﻲﮔﺬﺍﺭﻧﺪ‪ ،‬ﻣﺸﺎﻫﺪﻩ ﻣﻲﺷﻮﺩ ﻛﻪ ﺩﺭ ﺑﺪﻥ ﻓﺸﺎﺭﺧﻮﻥ ﺩﺭ ﺣﺪ ﺛﺎﺑﺘﻲ ﻧﮕﻪ‬
‫ﺩﺍﺷﺘﻪ ﻣﻲﺷﻮﺩ ﻛﻪ ﺍﻳﻦ ﻭﻇﻴﻔﻪ ﺑﻪ ﻋﻬﺪﻩ ﺳﻴﺴﺘﻢﻫﺎﻱ ﺗﻨﻈﻴﻢ ﻛﻨﻨﺪﻩ ﻓﺸﺎﺭ ﺷﺮﻳﺎﻧﻲ ﺍﺳﺖ‪.‬‬
‫ﺩﻭ ﻧﻮﻉ ﻋﻤﺪﻩ ﺳﻴﺴﺘﻢ ﻛﻨﺘﺮﻝ ﻓﺸﺎﺭ ﺷﺮﻳﺎﻧﻲ ﻭﺟﻮﺩ ﺩﺍﺭﺩ‪:‬‬
‫ﺍﻟﻒ( ﻣﻜﺎﻧﻴﺴﻢﻫﺎﻱ ﻋﻤﻞ ﻛﻨﻨﺪﻩ ﺳﺮﻳﻊ‪ :‬ﻛﻪ ﻇﺮﻑ ﭼﻨﺪ ﺛﺎﻧﻴﻪ ﻭﺍﺭﺩ ﻋﻤﻞ ﻣﻲﺷﻮﻧﺪ ﻭ ﻫﻤﮕﻲ ﺍﺯ ﻧﻮﻉ ﻋﺼﺒﻲ ﻣﻲﺑﺎﺷﻨﺪ ﻣﺎﻧﻨﺪ‬
‫ﻣﻜﺎﻧﻴﺴﻢ ﻓﻴﺪﺑﻜﻲ ﺑﺎﺭﻭﺭﺳﭙﺘﻮﺭﻱ‪ ،‬ﻣﻜﺎﻧﻴﺴﻢ ﺍﻳﺴﻜﻤﻴﻚ ﻋﺼﺒﻲ ﻣﺮﻛﺰﻱ ﻭ ﻣﻜﺎﻧﻴﺴﻢ ﮔﻴﺮﻧﺪﻩﻫﺎﻱ ﺷﻴﻤﻴﺎﻳﻲ‪.‬‬
‫ﺏ( ﻣﻜﺎﻧﻴﺴﻢﻫﺎﻱ ﻋﻤﻞ ﻛﻨﻨﺪﻩ ﻣﻴﺎﻥ ﻣﺪﺕ‪ :‬ﻣﺜﻞ ﺳﻴﺴﺘﻢ ﺭﻧﻴﻦ‪-‬ﺁﻧﮋﻳﻮﺗﻨﺴﻴﻦ ﺩﺭ ﻛﻠﻴﻪ ﻭ ﻫﻮﺭﻣﻮﻥ ﺁﻟﺪﻭﺳﺘﺮﻭﻥ ﻛﻪ ﺑﺎ ﻛﺎﻫﺶ‬
‫ﻳﺎ ﺍﻓﺰﺍﻳﺶ ﺣﺠﻢ ﺧﻮﻥ ﺑﻪ ﺗﻨﻈﻴﻢ ﻓﺸﺎﺭﺧﻮﻥ ﻛﻤﻚ ﻣﻲ ﻛﻨﺪ‪.‬‬
‫ﺝ( ﻣﻜﺎﻧﻴﺴﻢ ﺩﺭﺍﺯﻣﺪﺕ‪ :‬ﻛﻠﻴﻪﻫﺎ ﺩﺭ ﻋﺮﺽ ﭼﻨﺪ ﺭﻭﺯ ﺗﺎ ﭼﻨﺪ ﻫﻔﺘﻪ ﻣﻮﺟﺐ ﺗﺼﺤﻴﺢ ﻛﺎﻣﻞ ﻓﺸﺎﺭﺧﻮﻥ ﻣﻲﺷﻮﻧﺪ‪.‬‬

‫‪۴‬‬
 ‫ﻧﻜﺎﺕ ﺍﻳﻤﻨﻲ ‪:‬‬

‫ﭘﻮﺷﺶ ﻻﺳﺘﻴﻜﻲ ﺍﻧﺘﻬﺎﻱ ﻓﻠﺰﻱ ﮔﻮﺷﻲ ﺭﺍ ﻗﺒﻞ ﺍﺯ ﺍﻳﻨﻜﻪ ﺩﺭ ﮔﻮﺵ ﺑﮕﺬﺍﺭﻳﺪ ﺑﺎ ﺍﻟﻜﻞ ﺗﻤﻴﺰ ﻛﻨﻴﺪ ‪.‬‬
‫ﻫﺮ ﺩﻭ ﻗﺴﻤﺖ ﻓﻠﺰﻱ ﺭﺍ ﺩﺭ ﮔﻮﺵ ﻗﺮﺍﺭ ﺩﻫﻴﺪ ‪ .‬ﺩﺭ ﺑﻌﻀﻲ ﮔﻮﺷﻴﻬﺎ ﺩﻭ ﻃﺮﻑ ﮔﻮﺷﻲ ﻣﻮﺭﺏ ﻭ ﻛﻤﻲ ﺑﻪ ﺳﻤﺖ ﺟﻠﻮ ﻗﺮﺍﺭ ﺩﺍﺭﺩ‬
‫ﺗﺎ ﺩﺭ ﮔﻮﺵ ﺑﻬﺘﺮ ﻗﺮﺍﺭ ﮔﻴﺮﺩ‪.‬‬
‫ﻭﻗﺘﻲ ﺩﻭ ﻃﺮﻑ ﮔﻮﺷﻲ ﺭﺍ ﺩﺭ ﮔﻮﺷﻬﺎ ﮔﺬﺍﺷﺘﻴﺪ ‪ ،‬ﺩﺭ ﻗﺴﻤﺖ ﺑﻞ ﻳﺎ ﺩﻳﺎﻓﺮﺍﮔﻢ ﺻﺤﺒﺖ ﻧﻜﻨﻴﺪ ﻳﺎ ﺿﺮﺑﻪ ﻣﺤﻜﻢ ﻧﺰﻧﻴﺪ ‪ .‬ﺍﻳﻦ ﻛﺎﺭ‬
‫ﻣﻲ ﺗﻮﺍﻧﺪ ﺑﻪ ﮔﻮﺵ ﺁﺳﻴﺐ ﺟﺪﻱ ﺑﺮﺳﺎﻧﺪ ﻭ ﺍﮔﺮ ﺣﺠﻢ ﺻﺪﺍ ﺯﻳﺎﺩ ﺑﺎﺷﺪ ﺑﺎﻋﺚ ﻛﺎﻫﺶ ﺷﻨﻮﺍﺋﻲ ﻳﺎ ﻧﻘﺺ ﺷﻨﻮﺍﺋﻲ ﺷﻮﺩ‪.‬‬

‫ﭘﺮﺳﺶ‪:‬‬
‫‪ - 1‬ﺁﻳﺎ ﻣﻲﺷﻮﺩ ﺑﺎ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﻧﺒﺾ‪ ،‬ﻓﺸﺎﺭ ﺩﻳﺎﺳﺘﻮﻟﻴﻚ ﺭﺍ ﻣﺸﺨﺺ ﻧﻤﻮﺩ؟‬
‫‪ - 2‬ﺍﮔﺮ ﻓﺸﺎﺭ ﺳﻴﺴﺘﻮﻟﻴﻚ ﻓﺮﺩﻱ ‪ 210‬ﻣﻴﻠﻴﻤﺘﺮ ﺟﻴﻮﻩ ﺑﻮﺩ‪ ،‬ﺁﻳﺎ ﺑﺎﻳﺪ ﺑﺎﺯ ﻫﻢ ﻓﺸﺎﺭ ‪ Cuff‬ﺭﺍ ﺑﻪ ‪ 200‬ﻣﻴﻠﻴﻤﺘﺮ ﺟﻴﻮﻩ‬
‫ﺭﺳﺎﻧﺪ؟‬
‫‪ - 3‬ﺁﻳﺎ ﺑﺪﻭﻥ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ‪ Cuff‬ﻣﻲ ﺗﻮﺍﻥ ﺻﺪﺍﻱ ﻧﺒﺾ ﺭﺍ ﺑﻮﺳﻴﻠﻪ ﺍﺳﺘﺘﻮﺳﻜﻮپ ﺷﻨﻴﺪ؟‬
‫‪ - 4‬ﻋﺎﻣﻞ ﺍﻳﺠﺎﺩ ﻧﺒﺾ ﭼﻴﺴﺖ؟‬
‫‪ - 5‬ﻓﺸﺎﺭ ﺳﻴﺴﺘﻮﻟﻴﻚ ﻭ ﺩﻳﺎﺳﺘﻮﻟﻴﻚ ﺩﺭ ﺣﺎﻟﺖ ﻧﺸﺴﺘﻪ‪ ،‬ﺧﻮﺍﺑﻴﺪﻩ ﻭ ﺍﻳﺴﺘﺎﺩﻩ ﭼﻪ ﺗﻔﺎﻭﺗﻲ ﺩﺍﺭﻧﺪ؟ ﺩﻟﻴﻞ ﺁﻥ ﭼﻴﺴﺖ؟‬
‫‪ - 6‬ﺁﻳﺎ ﭘﺲ ﺍﺯ ‪ 20‬ﺑﺎﺭ ﻧﺸﺴﺘﻦ ﻭ ﺑﺮﺧﺎﺳﺘﻦ‪ ،‬ﻓﺸﺎﺭ ﺧﻮﻥ ﻭ ﺿﺮﺑﺎﻥ ﻗﻠﺐ ﺗﻐﻴﻴﺮ ﻣﻲ ﻛﻨﺪ؟‬
‫‪ 5 - 7‬ﺩﻗﻴﻘﻪ ﭘﺲ ﺍﺯ ﻭﺭﺯﺵ‪ ،‬ﻓﺸﺎﺭ ﺧﻮﻥ ﻭ ﺿﺮﺑﺎﻥ ﻗﻠﺐ ﺗﻐﻴﻴﺮ ﻣﻲ ﻛﻨﺪ؟‬
‫‪ - 8‬ﻓﺸﺎﺭ ﻧﺒﺾ ﻭ ﻓﺸﺎﺭ ﻣﺘﻮﺳﻂ ﺷﺮﻳﺎﻧﻲ ﺭﺍ ﻣﺤﺎﺳﺒﻪ ﻛﻨﻴﺪ‪.‬‬
‫‪ - 9‬ﺑﻪ ﻧﻈﺮ ﺷﻤﺎ ﻣﻲ ﺗﻮﺍﻥ ﻓﺸﺎﺭ ﺧﻮﻥ ﺭﺍ ﺍﺯ ﺳﺎﻕ ﭘﺎ ﮔﺮﻓﺖ؟ ﺩﺭ ﺍﻳﻦ ﺻﻮﺭﺕ ﭼﻪ ﺗﻔﺎﻭﺗﻲ ﺑﻴﻦ ﺍﻳﻦ ﻓﺸﺎﺭﺧﻮﻥ ﺑﺎ‬
‫ﻓﺸﺎﺭﺧﻮﻥ ﺑﺪﺳﺖ ﺍﻣﺪﻩ ﺍﺯ ﺩﺳﺖ ﻭﺟﻮﺩ ﺩﺍﺭﺩ؟‬
‫‪- 10‬ﺍﮔﺮ ﭘﻴﭻ ﻣﺨﺼﻮﺹ ﭘﻤﭗ ﺭﺍ ﻳﻜﺒﺎﺭﻩ ﺑﺎﺯ ﻛﻨﺪ‪ ،‬ﺁﻳﺎ ﻓﺸﺎﺭﺧﻮﻧﻲ ﻛﻪ ﺑﻪ ﺩﺳﺖ ﻣﻲﺁﻳﺪ ﺭﻗﻢ ﺻﺤﻴﺤﻲ ﺭﺍ ﻧﺸﺎﻥ ﻣﻲ ﺩﻫﺪ‬
‫ﻳﺎ ﺧﻴﺮ؟ ﭼﺮﺍ؟‬

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